Malaria prevention needed...

[MR2-BLUE]

...between Maputo and Kozi Bay ?

We plan a trip in the last week of November in that area - do we need any Malaria prevention (i.e. Malerone, etc) - what is the experts reco ?

[4ePajero]

A friend of mine, his wife, sister and BIL went to Moz for a long weekend.

"It' only a weekend, so why bother"

A week after they returned, they had his sister's funeral.

She died of cerebral malaria.
Three days after their return, he started feeling badly (like flu).
24hrs later she was dead.

[LS d2]

not worth risking it....it is def high risk area, best is to contact a travel clinic they are very clued up and helpful

http://www.travelclinic.co.za/live/index.php

[Wolf-]

Prevention is always better than cure, besides the medicinal option also take lots of peacefull sleep / tabbard, mosquito nets if possible, try and cover up ie long pants and long sleeves at dusk, mosquito coils etc etc you get the picture, If you can prevent being bitten then all the better.

[4ePikanini]

Also remember the period afterwards that you are not allowed to give blood if you are a donor.

[kev500sa]

Hi, I'm working in Moz. I have 38 expats working for me. All of them have had malaria, one died as a result. The company doctor now recommends the following: MALANIL (Atovaquane + proguanil) one tablet daily starting 2 days before and 7 days after. This is recommended for the particular strain of malaria we get here. Cheers.

[ArrieMeyer]

YES!!!!!!!

Two of my friends dead ca. 10 years ago after working in that area.


Listen to Kev500 and Wolf, they have given the best advice.

[MR2-BLUE]

Thanks for the advices - that rather sounds to go there at a different time in the year...

[ArrieMeyer]

Thanks for the advices - that rather sounds to go there at a different time in the year...

No, MR2, summer is beautiful there.

Just take the precautions and make sure that you are not bitten.

The TABARD candles, spray and stick works well. Also burn a mosquito coil at your feet around the campfire in the evening.


Usually they are not on the beach, mozzies don't like wind.


Finally, for six weeks afterwards, if you feel like you have a cold, have the malaria test done. It costs about R 80-00 and most medical aid shemes will pay for it.


My friends were too macho to take the precautions. Don't miss out; the precautions are available and effective. And in that area, the time of year does not really make a difference.

[Henris]

We don't use them. Just respect the mozzies and anticipate them.

Long sleeves and long trousers at night. Mozzie nets, always.

PS. If we were on permanent mozzie meds, we wouldn't have kidneys any more and a solid liver.

[ArrieMeyer]

Just respect the mozzies and anticipate them.

Agree, Henri, that's the most important. We also have not been using the pills for decades, but our overseas family and their friends feel safer when they use it.

Also important is: wheneever you are near fresh water or green grass in the veld, they will also be around during the day. Use the TABARD!

(DRINK G&T's)

[Henris]

It seems that if you are not exposed, you are more susceptible.

The guys up north, zim, zam, moz, don't use anything and they pick it up a lot less than the tourists.

[The Big Silver Hole]

I got advice from a doctor in Uganda, do not use meds, only hippititus and yellow fever. If you get it, you can see it quickly (not masked) treat it aggresively.

I worked many months in East Africa, got cerebral malaria once, for a good few hours I was worried that I would not die. Identified it quickly and treated aggresively.

It is a tough decision to make imho.

We did drink lots of Rum and ate plenty of garlic. Long sleeves, tabbart, fans etc.

[Grason]

I spent 6 years in Africa. Angola, Nigeria, DRC & Zambia. All the Maleria medication, they recommended that I do not stay on it for extended periods.
I came across a herbal maleria tablet. This has since been changed and now comes in drops. These drops are used daily and on the one occation that I got maleria, it was not bad at all and the Company (Herbal Africa) recommended that I changed the dosage that I was using for the following 3 - 4 days. All sorted out, with no side effects whatsoever.

The drops are called "X-Maleria" and I got them from a Company called Herbal Africa. They do have a web site if you would like to go and have a look at what it is all about.

Disclaimer: Maleria is a very serious disease & must not be taken lightly! My choice was based on my own research and I was happy to take the risk.

P.S: My team of 40 guys were on the same 'drops', none of them contracted serious maleria, nor had any side effects.

[dudley]

I got advice from a doctor in Uganda, do not use meds, only hippititus and yellow fever. If you get it, you can see it quickly (not masked) treat it aggresively.

I worked many months in East Africa, got cerebral malaria once, for a good few hours I was worried that I would not die. Identified it quickly and treated aggresively.

It is a tough decision to make imho.

We did drink lots of Rum and ate plenty of garlic. Long sleeves, tabbart, fans etc.

Dr. Neethling du Toit (entomologist) of Nelspruit has the same advice. He reckons that often the profilactics only mask the symptoms and renders the whole situation much more dangerous, as the parasite then gets time to develop inside you. One must make up your own mind.

When in India the travel clinic in Cape Town supplied us with a broad spectrum antibiotic which you took when going into the danger area and stopped when leaving the area. Also helped keep Delhi belly at bay as an added bonus, I suppose. I have personally, besides the antibiotics in India, never taken something, and tried really hard to not get bitten. So far just lucky, I suppose.

Gin and tonic may be the drink of choice, as it may also help prevent or treat malaria (the quinine in the tonic water).

[Tony Weaver]

Sigh .... every time malaria gets discussed on this forum, bad advice gets given. I'm pasting below what Francois Maartens wrote many months ago, and below that, what I wrote on the subject.

Francois wrote: I have been involved in malaria control and research in most African countries for the last 10 years and here my 2 cents worth on the topic.

There are 5 malaria strains in the world and the most common one (90% of all recorded cases) in Africa is called plasmodium falciparum. Untreated plasmodium falciparum turns into cerebral malaria and that is why a child dies of malaria every 30 seconds in Africa.

The debate about prophylactic drugs “masking” the malaria symptoms is the biggest myth and it claims many lives every year. In a nut shell – if you contract malaria in Africa, there is a 90% chance that it is plasmodium falciparum so it will turn into cerebral malaria if you don’t treat it. Prophylactic drugs are basically an antibiotic and if you do not complete the course then it will not help.

Common myths concerning malaria:

It is better not to take any prophylactic drugs as it masks the symptoms and makes diagnosis difficult.

This is incorrect, prophylactic drugs suppress and prevent parasite development and therefore even if not totally effective due to non compliance or partial drug resistance, symptoms tend to take longer to appear, may be less severe at first and development of complications is less likely. In a complete absence of drugs, parasites are able to multiply rapidly and malaria can quickly get out of hand leading to severe complications and possible death.

There is a new deadly strain of malaria.

Cerebral malaria is not a new strain; it is complicated plasmodium falsiparum malaria. Early diagnosis and appropriate treatment prevents the development of complicated malaria that develops into cerebral malaria.

Malaria cannot be cured once infected.

This is incorrect; malaria can be effectively cured with the appropriate treatment. Atemisinin based combination therapies (ACT’s) which consist of a combination of drugs is a highly effective malaria treatment and can rid malaria parasites from patients effectively.

Prophylactic drugs need only be taken while in a malaria area.

The prophylactic malaria drugs kill malaria parasites once it enters the red blood cells. This does not occur until 10 to 14 days after being bitten by an infected mosquito. If the drugs are stopped before the parasite reaches the blood cells, there will not be enough drugs in the blood to kill the parasite and the prophylactic drug will fail. It is therefore very important to continue taking the prophylactic drug for up to 4 weeks or longer depending on the drug after leaving a malaria area.

I was not bitten, can I stop taking my prophylactic drugs?

The female anophelesmosquito does not make a sound when she flies so it is difficult to know if and when you are bitten. The reaction of her bite may also not be as pronounced as it is with other mosquitoes so it’s always advisable to complete all malaria prophylactic drugs.

Hope this helps and feel free to check out our website for more information. http://www.fightingmalaria.org/
There is some useful info under the FAQ section.

Regards

Francois Maartens
Africa Fighting Malaria
E-mail – [email protected]
Tel – 031 205 8637
Mobile – 083 655 4173





12-02-08, 12:20 PM
Tony Weaver
Member
Join Date: Feb 2008
Location: Cape Town
Age: 53
Posts: 555



Hi Francois and all others on this thread,

Wise words Francois: I have also researched and written extensively on malaria, and the biggest myth is that taking prophylaxis is dangerous. Dying of malaria is more dangerous. I have had malaria three times, and every time it was contracted when I came off prophylaxis because of medical reasons (having to take a break from Lariam because you can't take it for more then three months; taking a break because of hepatitis).

Yes, the first rule is to sleep under a net, cover up, wear long sleeves, socks and pants, slap on plenty of Tabard or Peaceful Sleep (both are equally good), don't sleep near standing water or under a mango tree, and get tested the minute you feel any flu like symptoms.

BUT the big three prophylactics are between 80% and 96% effective. It is essential that you get medical advice from an expert (SAA travel clinic or other) as to which one to use. I have used Lariam for years with no side-effects, but my wife can't use it and she uses Doxy. My son and daughter both use combination therapy.

I have seen too many good people die because they didn't believe in prophylaxis. And yes, if you live in a malaria-infested area, then often the advice is not to take prophylaxis because it can do long term damage, and you do build up a level of immunity after lengthy exposure. But for us in-and-out travellers, take the pills.

And for a longer trip to remote areas, carry both a rapid testing kit and the recommended treatment medicines.
__________________

[Biggles]

The debate will rage on about about prophalytics. When i had malaria the first time I was on Larium. I don't think anyone will garentee that any prophalytics will stop you getting Malaria.

I stopped counting at 15 infections (all my own fault sitting on beaches in Ghana till the wee hours getting pissed and nightshift standing under big lighting plants doesn't help). I wised up in the DRC and went two years of no infections. Prevention is the best course. Lots of tabard, long sleeves, long trousers, ect. a friend had his family in Ghana including 2 kids from newborns and they never had an infection in the whole family for 4 years. They were paraniod and stayed indoors from before dusk aircons running full blast. But if you are in or its been 2 weeks since you were in a malaria area and you feel bad. Flu type symptoms go to the doctor ASAP and tell them you were in a malaria area and insist on a blood check. Self test kits are not 100%.

[MikeAG]

Well said Tony......and I can't believe that this subject has any sort of controversy about it. It is plainly different for those living permanently or long-term in a malarial area, but short-term visitors just shouldn't be taking any risks.

I attach a photo of us camping on the Zambezi in August. There aren't many mosquitoes about at that time of year..........but you only need one! Note the tent up and zipped shut before dusk, and everyone with long sleeves and long trousers..........even tucked into socks! Laura is actually applying insect repellant whilst her friend pulls on a long sleeve top.

I am an absolute dictator when it comes to malarial protection on my trips. In 6 months across the whole of the African continent a few years ago, our party of up to 8 people received a total of only 3 mosquito bites between us. With the Lariam that gave us the best possible chance of staying healthy. We regularly saw South Africans in shorts on Lake Malawi beaches through dusk and into the early hours, despite it being one of the highest risk areas in the world.

Mike

[Tony Weaver]

The other thing we do before every trip into a malarial area is that we soak all our clothes in Peripel. It's made by Bayer, and is available from some pharmacies, and also from travel health clinics. One sachet does five litres of water, you soak the clothes (use gloves) hang them up to dry while still dripping wet, and it lasts for several washes.

Repels mozzies, pepper ticks, midges - works for everything, in fact, except .... the dreaded tsetses.

[MR2-BLUE]

Again - THANKS for all the advices and guidance....well appreciated.

When looking with my wife into the answers, we decided not to go at that time of the year as we both hate to spend the summer evenings with long sleeves,pants and socks...surrounded by ugly smelling candles.

She also leaves to Europe a week later for the X-Mas period and the docs overseas are not really familiar with Malaria treatment - we consider this risk simply to high.